Rectal cancer surgery is technically demanding, especially in males. Robotic assistance may help overcome these challenges. This study aimed to identify factors associated with robotic-assisted proctectomy in rectal cancer.

High output is a common cause for readmission after new ileostomy creation. The loss of sodium leads to compensatory activation of the renin-angiotensin-aldosterone system (RAAS). Angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) are first-line therapy for hypertension in the United States. We hypothesized that concurrent use of ACEI/ARB increases the risk of readmission following new ileostomy creation due to the loss of this compensatory mechanism.

Medical and surgical care remain a critical feature of disaster preparedness. The evolution of modern warfare introduces elements manifesting as both domestic and foreign terrorism. The fields of disaster and counterterrorism medicine continue to evolve in response to these looming threats. While perhaps not common, education, preparedness, and medical/surgical capabilities are paramount to an effective disaster and counterterrorism medical (and surgical) response. The present study examines the specific role of the surgeon within the scope of disaster and counterterrorism medicine.

It is not every day that true scientific pioneers come along. Fortunately, the early 20 century gifted us with immensely talented professionals like Dr Eugene Opie, who set the groundwork for Dr Juan Acosta and his associates to make revolutionary advancements on the pathophysiologic origin and proper management of acute biliary pancreatitis. Amidst a modest hospital in the rural town of Rosario, Argentina, Dr Acosta pioneered numerous studies to validate his hypothesis that transient gallstone obstruction of the lumen was the true source of acute biliary pancreatitis. His findings, along with his mentorship within his residency program, and his dedication to improving patient outcomes, have cemented his name into patient care as we know it today. The goal of this paper is to outline the relentless dedication of Dr Acosta to the improvement of patient care and pancreatitis management.

While minimally invasive pancreaticoduodenectomy (MIPD) has historically demonstrated benefits over open pancreaticoduodenectomy (OPD), recent advances in perioperative care and surgical techniques may have impacted the relative advantages of these two approaches. This contemporary analysis examines national trends to assess potential differences in resource utilization metrics along with perioperative outcomes between the two approaches. We analyzed the Nationwide Inpatient Sample database for cancer patients who underwent pancreaticoduodenectomies from 2016 through 2020. We compared socio-demographics, length of stay (LOS), total charges, and perioperative complications between MIPD and OPD. In this observational study, MIPD was associated with lower total charges ($97,470 vs $126,586), shorter LOS (5.05 vs 7.37 days), and lower odds of perioperative complications (OR 1.40, 95% CI 1.18-1.65) compared to OPD. While total charges increased similarly in both groups over time, a declining trend in LOS was observed for OPD (11.49 to 10.36 days). Non-white race and private/other insurance correlated with longer stays, higher charges, and more complications regardless of surgical approach. Despite the gradual improvements in LOS observed with OPD, MIPD demonstrated advantages in resource utilization metrics, indicating potential for reduced healthcare utilization and costs compared to the open surgical approach during the study period. Continued prospective investigation is warranted to comprehensively evaluate MIPD's value proposition.

Patients residing in rural and frontier areas experience worse thyroid cancer outcomes than those in urban areas. This novel qualitative study sought the perspectives of rural surgeons to identify practical measures that could mitigate the disparities in thyroid cancer care between rural and urban contexts.

Superior Mesenteric Artery Syndrome (SMAS) is a very rare disease that causes starvation and malnutrition secondary to a mechanical obstruction of the 3 portion of the duodenum between the superior mesenteric artery and aorta. Long-term outcomes following surgery for SMAS by current methods have a high failure rate of 21%-67%. We report the 3-year outcomes of a novel operation for SMAS described as the duodenoduodenostomy (DD).

Japan currently has a super-aged society, with a rapid increase in elderly patients in need of medical care. Determining treatment strategies for acute cholecystitis (AC) in very elderly patients with various comorbidities is often difficult. Although percutaneous cholecystostomy (PC) is a less-invasive treatment option, its impact on subsequent surgery remains debatable. This study investigated the validity of PC as a bridge to surgery in very elderly patients with AC.

Traumatic injury is associated with significant mental health morbidity. To evaluate the need for implementation of active-post injury mental health screening at a Level 1 Pediatric Trauma center, we aimed to characterize all new mental health diagnoses after injury and evaluated for patient or injury factors that may aid in targeting of future screening.

The death of trauma patients with low injury severity scores (ISS) may not be fully explained by the severity of their injuries. Our objective was to evaluate preexisting conditions (PECs) that may contribute to the mortality rate of and hospital resources consumed by patients with low ISS.

Trauma and pre-existing conditions (PECs) can independently impact patient hospital length of stay (H-LOS) or intensive care unit (ICU) ICU-LOS. Pre-existing conditions impact on LOS has rarely been studied in older trauma patients aged ≥55. Our purpose is to examine the relationship between PEC status and ICU-LOS and H-LOS in this population.

Malignancy in pilonidal sinus disease (PSD) is rare, with squamous cell carcinoma (SCC) being the most common type. This study aims to assess the incidence of malignancy in PSD and identify risk factors to guide more targeted pathological examination strategies.

Transcatheter aortic valve replacement (TAVR) is an established treatment for patients with severe aortic stenosis (AS). It remains unclear whether disparities exist in rural or socially vulnerable populations undergoing TAVR. This study assessed whether outcomes differ based on geographic location or vulnerability of patients undergoing TAVR.

Short-term outcomes after pancreatoduodenectomy (PD) are well-studied, but long-term reoperation rates and their indications remain poorly characterized.

For difficult cholecystectomies, bail out procedures (BOP) are performed to mitigate risk of patient harm.

Inguinal hernia repair, particularly using TAPP, is common in males, and acclaimed for minimal invasiveness but often complicated by seromas, significantly affecting recovery and health care costs.

Sepsis is a severe clinical syndrome with high morbidity and mortality in intensive care units (ICUs). Body Mass Index (BMI) shows a rising trend of obese patients being admitted to ICUs. The relationship between BMI and the clinical outcome of sepsis remains highly debated.